机器人辅助腹腔镜手术在复杂大子宫切除术中的应用探讨(附手术视频)  

Exploration of robot-assisted laparoscopic hysterectomy for complex enlarged uterus(with surgical video)

作　　者：李博巍 马少寒 祁馨仪 李贝 陈修鑫 张瑞琪 刘淑曼 刘聪 哈春芳[2] LI Bowei;MA Shaohan;QI Xinyi;LI Bei;CHEN Xiuxin;ZHANG Ruiqi;LIU Shuman;LIU Cong;HA Chunfang(The First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Department of Gynecology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学第一临床医学院,宁夏银川750004 [2]宁夏医科大学总医院妇科,宁夏银川750004

出　　处：《机器人外科学杂志（中英文）》2024年第4期626-632,共7页Chinese Journal of Robotic Surgery

基　　金：宁夏回族自治区重点研发计划项目(2023BEG01001)。

摘　　要：目的:探讨机器人辅助腹腔镜手术在复杂大子宫切除术中的临床疗效及优势,为临床诊治过程提供个体化选择。方法:回顾性分析2021年4月—2023年11月就诊于宁夏医科大学总医院行子宫全切术的193例患者的临床资料,根据术式分为机器人组和腹腔镜组,分别为82例和111例。根据两组患者的临床资料数据,统计分析患者一般资料、围手术期指标、并发症情况,以及大子宫人群和巨大子宫人群围手术期指标。结果:机器人组患者的术中出血量、术中输血率、术后胃肠功能恢复时间、术后住院时间、术后12 h VAS评分、术后并发症发生率均显著优于腹腔镜组,而两组患者在术中并发症发生率和手术时长方面,差异无统计学意义。在大子宫患者中,机器人组较腹腔镜组术中输血率降低,术后胃肠功能恢复时间缩短。在巨大子宫患者中,机器人组较腹腔镜组手术时长缩短,术中出血量减少,术中输血率降低,术后胃肠功能恢复时间缩短,术后住院时间增长。结论:机器人辅助腹腔镜下复杂大子宫切除术不仅可行、安全,而且有助于患者快速康复,值得在临床上进一步推广使用。Objective:To investigate the clinical efficacy and advantages of robot-assisted laparoscopic hysterectomy for complex enlarged uterus,and to provide individualized options for the clinical diagnosis and treatment decision.Methods:The clinical data of 193 patients who underwent robot-assisted laparoscopic hysterectomy for complex enlarged uterus in the General Hospital of Ningxia Medical University from April 2021 to November 2023 were retrospectively analyzed.They were divided into the robotic group(n=82)and the laparoscopic group(n=111)according to different surgical methods.The general data,perioperative indicators,complications,and perioperative indexes of large and giant uterus population were statistically analyzed.Results:Intraoperative bleeding,intraoperative blood transfusion rate,postoperative gastrointestinal function recovery time,postoperative hospitalization time,postoperative 12 h VAS scores,and postoperative complication rate of patients in the robotic group were significantly better than those in the laparoscopic group.However,there was no statistically significant difference between the two groups in terms of the incidence of intraoperative complication rate and operative time.In patients with large uterus,the robotic group had a lower intraoperative blood transfusion rate and shorter gastrointestinal function recovery time after surgery than the laparoscopic group.In patients with giant uterus,the robotic group showed shorter operative time,less intraoperative bleeding,lower intraoperative blood transfusion rate,shorter gastrointestinal function recovery time after surgery,longer postoperative hospitalization time than the laparoscopic group.Conclusion:Robot-assisted laparoscopic hysterectomy for enlarged uterus is safe and feasible,,and could help patients recover quickly,which is worthy of clinical promotion.

关 键 词：机器人辅助手术 腹腔镜手术 复杂大子宫 子宫全切术 

分 类 号：R737.33[医药卫生—肿瘤]